Before reading this post, we encourage you to read “Behavioral and Mental Health Emergency Response” as it lays a solid foundation for managing patients experiencing behavioral or mental health emergencies.

Once you’ve read that, these tips for talking to a patient about suicide will add an additional layer of insight and education for this specific set of patients. Suicide attempts and suicidal ideation, or the contemplation of suicide, are challenging to navigate as an EMS or other healthcare provider. Therefore, educating oneself on how we can best talk to, build rapport with, and ensure the safety and continued management of these patients is crucial.

Tips for Talking to Patients about Suicide

1. It’s okay to ask. There is a long-held belief that simply asking someone if they’re thinking about suicide could make them more suicidal. Thankfully, this is simply untrue: numerous studies have looked at this concern, and none have found a statistically significant increase in suicidality after patients were asked about suicidal ideation.¹ While asking about suicidal thoughts can be daunting at first, it will get easier with practice: “Have you been thinking about harming yourself?” is a simple, straightforward way to start.
2. Start by gathering information about the situation. In a study that examined conversations between help-line counselors and people experiencing crisis, ambiguity was a strong predictor of whether the conversation made the person reaching out for help feel any better, including conversations specifically about suicide.² Further, the study found that more successful counselors reacted strongly to ambiguity, working to quickly clarify the issue to understand and address the problem fully.² Asking open-ended follow-up questions and practicing active listening are good techniques for gathering information.
3. Focus on empathy and affirmation. Another analysis of help-line conversations found that those seeking help found conversations high in affirmations and empathetic statements from the crisis counselor more beneficial.³ While professional mental health workers may need to balance affirmation and empathy with problem-solving, EMS is largely tasked with getting suicidal patients safely to definitive care. Use statements that reassure the patient that you hear them and their concerns are valid, like “That must be overwhelming,” “I can see how that would be frightening,” or “It sounds like you have a lot of responsibilities; that must be a heavy weight to carry.” Additionally, you can recognize strength in the patient. For example, when someone shares that they are having thoughts of suicide, you might respond with, “Thank you for being so open with me; it takes a brave person to do that.”
4. Suicide affects us all. Finally, remember that first responders aren’t immune to suicidal thoughts. The rate of suicide is higher among first responders than the general public.⁴ Keep a close eye on your coworkers, and don’t be afraid to check in if you think they might need help (or, conversely, if you need help yourself). Suicidal thoughts are prevalent enough to be part of the human experience—nearly half of the population reports having suicidal thoughts at some point in their life.⁴ If you have had thoughts of suicide in the past, sharing that fact can be a powerful way to build rapport and let your patient or coworker know that they are not alone in their fight.